Our client is seeking Remote Medical Claims Examiner

Candidates must have their own PC or laptop with Windows 11. This is not optional. Windows 11 is required to access systems, Citrix, and all claims platforms. Applicants must already have a personal computer running Windows 11 before applying.

This role reviews and processes medical claims, verifies eligibility, checks coding accuracy, and applies correct benefits according to policy guidelines. Candidates must have at least 3 years of experience processing medical claims specifically on the payer side. This experience is required and must be recent. Please do not apply unless you have a minimum of three years of payer-side claims adjudication experience.

The position requires strong knowledge of medical terminology, ICD, CPT, HCPCS, EOBs, and claims adjudication procedures. Candidates must be able to handle a high-volume workload while maintaining accuracy and meeting production standards. A high school diploma or GED is required. The job is fully remote, but again, candidates must use their own PC or laptop with Windows 11 to perform the work.

Applicants with payer-side experience, managed care experience, or experience reviewing medical records and processing Medi-Cal, Medicare, or commercial claims are strongly preferred. This is a stable remote opportunity offering long-term growth for experienced medical claims examiners.


Apply for this great position as a REMOTE CLAIMS EXAMINER - Send resume to Yarely Villalpando - yvillalpando(@)appleone.com

Equal Opportunity Employer / Disabled / Protected Veterans

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